Traumatisierte Menschen haben mit vorübergehenden oder anhaltenden Symbolisierungsschwierigkeiten zu kämpfen. Diese treten entweder in psychisch eingekapselter, umgrenzter Form in Erscheinung oder als psychische Funktionsabläufe, die sich in umfassenderer Weise auf die Lebensprojekte, politischen Einstellungen und kulturellen Normvorstellungen der Person auswirken, und zeigen sich in ihrer Körper-Welt-Beziehung, ihrer Individuum-Gruppen-Beziehung und/oder ihrer Individuum-Diskurs-Beziehung. Die Schwierigkeiten können in imaginativen und symbolischen Funktionsmodi auftreten. Gravierende Störungen der Symbolisierung lassen sich aus psychoanalytischer Sicht beschreiben als Begleiterscheinungen der paranoid-schizoiden und der autistisch-berührenden Position (Ogden), als Evakuierung (...) von Beta-Elementen in den Körper (Bion), als Verwerfung (Lacan) und als Urverdrängung (Freud). Der vorliegende Beitrag stellt einige psychoanalytisch fundierte semiotische Überlegungen vor, die dem Forschungsfeld Trauma und Psychose entstammen. Anhand von Fallbeispielen werden der Zusammenbruch der Symbolisierung, Fixierungen auf den nichtsymbolischen Modus der psychischen Repräsentation und die Re-Symbolisierung erläutert, die sich dank der kreativen transformativen Intervention des Analytikers vollzieht. (shrink)

Introduction -- Running away from revenge -- Just deserts -- The emotions of revenge -- The science of mad -- Why we punish? -- Other cultures and revenge -- When self-help is permissible -- Release revenge.

Causality is central to the understanding and use of data; without an understanding of cause and effect relationships, we cannot use data to answer important questions in medicine and many other fields.

Das Phänomen des Amateurkünstlers und Dilettanten zählt zu den bisher kaum beachteten Gegenständen der kunsthistorischen Forschung. Das Werk dieser Schaffenden darf gleichwohl als ein entscheidender Beitrag zur Kunst- und Künstlergeschichte des 18. Jahrhunderts verstanden werden. Unter einem Dilettanten versteht man gemeinhin einen Laien und Stümper, welcher dem Metier, in dem er sich versucht, eher Schaden als Nutzen bringt. Dabei wird ausser Acht gelassen, dass sich künstlerisch begabte Personen vor allem deshalb als Dilettanten bezeichneten, um sich vom professionellen Künstler abzugrenzen. Dilettieren (...) wurde als eine dem Adel vorbehaltene exklusive Form der Kunstausübung verstanden, die sich weder finanziellen Interessen noch dem Geschmack eines grösseren Publikums unterwerfen musste und sich somit kreative Freiräume ermöglichte. (shrink)

We hear that a glass of red wine prolongs life, that alcohol is a carcinogen, that pregnant women should drink not a drop of alcohol. Major medical journals first claimed that hormone replacement therapy reduces the risk of heart disease, then reversed themselves and said it increases the risk of heart disease. What are the effects caused by consuming alcohol or by receiving hormone replacement therapy? These are causal questions, questions about the effects caused by treatments, policies or preventable exposures. (...) Some causal questions can be studied in randomized trials, in which a coin is flipped to decide the treatment for the next experimental subject. Because randomized trials are not always practical, nor always ethical, many causal questions are investigated in non-randomized observational studies. The reversal of opinion about hormone replacement therapy occurred when a randomized clinical trial contradicted a series of earlier observational studies. Using minimal mathematics - high school algebra and coin flips -- and numerous examples, Observation and Experiment explains the key concepts and methods of causal inference. Examples of randomized experiments and observational studies are drawn from clinical medicine, economics, public health and epidemiology, clinical psychology and psychiatry. (shrink)

Making Social Science Matter presents an exciting new approach to the social and behavioral sciences including theoretical argument, methodological guidelines, and examples of practical application. Why has social science failed in attempts to emulate natural science and produce normal theory? Bent Flyvbjerg argues that the strength of social sciences lies in its rich, reflexive analysis of values and power, essential to the social and economic development of any society. Richly informed, powerfully argued, and clearly written, this book opens up (...) a new future for the social sciences. Its empowering message will make it required reading for students and academics across the social and behavioral sciences. (shrink)

This article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical–economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology (...) for a future context. It is a question about which nursing theories and what nursing knowledge should be developed in order to benefit patients and relatives of the future. We suggest that future knowledge development in nursing be developed in an interchange between theory and practice and guided by philosophy like a kind of pendulum where all three elements are treated as equals. We suggest a framework for the development of nursing knowledge based on a caring‐ethical practice, a theory on life phenomena in suffering and relationship‐based nursing, and thereby, we may be able to help patients to be cured, to recover, to be alleviated or comforted when suffering. (shrink)

A theory of learning for the future advocates the teaching of a preparedness to respond in a creative way to difference and otherness. This includes an ability to act imaginatively in situations of uncertainties. John Dewey’s pragmatism holds the key to such a learning theory his view of the continuous meetings of individuals and environments as experimental and playful. That pragmatism has not yet been acknowledged as a relevant learning theory for the future may be due to the immediate connotation (...) and the many interpretations associated with the term ‘experience’, which is at the heart of Dewey’s educational thinking. Dewey defi ned experience in a way that is not well understood within educational research, and in a way that is easily confused with the term ‘experiential learning’. The latter refers to the importance of participants’ ‘experiences’ derived from bodily actions and stored in memory as more or less tacit knowledge. (shrink)

Daniel is 35, successful, a high level professional and an accomplished academic - yet he is also a virgin, who fears that he will spend the rest of his life alone. More importantly, Daniel has existed in an emotional bubble all of his life, and has had no intimate friendships. In other words, he is not fully alive, and seeks psychotherapy because he is haunted by not understanding what is wrong with him. He is attractive to women, yet as soon (...) as a woman tries to get close to him, he runs away. Lacking an inner foundation, he fears that women will annihilate him, like his overbearing mother who abused him as a child. Quite simply, this book is an unprecedented achievement, taking the reader into actual psychoanalytic sessions and sharing with the reader Michael Shoshani Rosenbaum’s dialogues with Daniel, vividly illustrating his pain and struggle to transcend his existential plight. Furthermore, as the author of two sections of the book, Daniel himself provides a rare, insightful view from the other side of the couch, illuminating the challenge and change experienced within the other half of the therapeutic relationship. It is a compelling psychological adventure, fusing together the intimacy of the therapy with an account of the revolutionary changes that have occurred in the practice of psychotherapy and psychoanalysis over the last decades. Daniel is like no one else, and yet he is everyone, making this book a must for every person searching for self-knowledge, allowing the reader to identify with Daniel and his struggle to become human. (shrink)

James cornman and r routley and v macrae have argued that the principle of identity (alias leibniz's law) is inconsistent with certain plausible and widely accepted identity statements; e.G., "the temperature of a gas is identical with the mean kinetic energy of the molecules of the gas." they argue on this ground that the principle of identity should be modified to remove this appearance of inconsistency. The requisite modification however, Removes whatever "metaphysical teeth" the unmodified version might have had. I (...) argue in this paper that such attacks on the principle of identity are utterly unwarranted. (shrink)

Real Social Science presents a new, hands-on approach to social inquiry. The theoretical and methodological ideas behind the book, inspired by Aristotelian phronesis, represent an original perspective within the social sciences, and this volume gives readers for the first time a set of studies exemplifying what applied phronesis looks like in practice. The reflexive analysis of values and power gives new meaning to the impact of research on policy and practice. Real Social Science is a major step forward in a (...) novel and thriving field of research. This book will benefit scholars, researchers and students who want to make a difference in practice, not just in the academy. Its message will make it essential reading for students and academics across the social sciences. (shrink)

In the article, we propose to frame organizational learning as inquiry into and resolving tensions arising from the performance of different commitments to work and its organizing. We expand learning as participation with its focus upon identity and membership to the development of work and the experiences and knowledge of its participants. The proposal is inspired by pragmatist philosophy both through its emphasis on learning as ascribing meaning to experience and its sociological version, symbolic interactionism with its emphasis on work (...) and its organizing in social arenas/worlds. We show that a pragmatist learning theory, founded on principles of non-dualistic, non-hierarchy, and a non-linear view on relations, thinking and practice aligns well with the proposed refurbished learning approach via complexity theory in this special issue. Further, we propose that Dewey’s pragmatism adds an important feature to a refurbished theory of learning in organizations by emphasizing the tensional and uncertain aspects of situations as contextual wholes that for a pragmatist learning theory constitute the analytical point of departure. (shrink)

In recent years, there have been many attempts at defining learning as a social phenomenon as opposed to an individual and primarily psychological matter. The move towards understanding learning as social processes has also altered the concept of knowledge as a well-defined element stored in books, brains, CD-Roms, disks, videos or on the Internet. Instead, knowledge has been perceived as a social and context related construction. The roots of the social angle within theories on learning and knowledge are much older (...) than the current literature suggests. This paper illustrates how these theories can be traced back to pragmatism as a philosophy and foundation for an educational approach introduced by the American, John Dewey, more than one hundred years ago. The paper also suggests that Dewey avoids some pitfalls that have come with the new theories, particularly the strong division between individual vs. social and school vs. everyday life learning. (shrink)

The emergence of new platforms for public communication, public deliberation, and public action presents new possibilities for forming, organizing, and mobilizing public bodies, which invite philosophical reflection concerning the standards we currently look to for coordinating public movements and for evaluating their effects. Developing a broad understanding of public philosophy, this article begins with the view of philosophy and intellectual freedom articulated in Kant's publicly oriented writings. We then focus on the power of philosophical discourse to form and further articulate (...) public bodies. Drawing on Dewey's work, we discuss the role of philosophical discourse in the articulation of publics into self-regulated, sovereign entities. We conclude with an account of how publishing itself might come to play an important role in the practice of public philosophy in a digital age. (shrink)

Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

BackgroundBefore participation in medical research an informed consent must be obtained. This study investigates whether the readability of patient information and consent documents corresponds to the average educational level of participants in rheumatological studies in the Netherlands, Denmark, and Norway.Methods24 PICDs from studies were collected and readability was assessed independently using the Gunning’s Fog Index and Simple Measure of Gobbledygook grading.ResultsThe mean score for the FOG and SMOG grades were 14.2 and 14.2 respectively. The mean FOG and SMOG grades were (...) 12.7 and 13.3 in the Dutch studies, 15.0 and 14.9 in the Danish studies, and 14.6 and 14.3 in the Norwegian studies, respectively. Out of the 2865 participants, more than 57 % had a lower educational level than the highest readability score calculated in the individual study.ConclusionsAs the readability level of the PICDs did not match the participants’ educational level, consent may not have been valid, as the participants may have had a limited understanding of what they agreed to participate in. There should be more focus on the readability of PICDs. National guidelines for how to write clear and unambiguous PICDs in simple and easily understandable language could increase the focus on the readability of PICD. (shrink)

The current study analyzes trans-cultural universalities and specificities in the recognition of status roles, dominance perception and social evaluation based on nonverbal cues. Using a novel methodology, which allowed to mask clues to ethnicity and cultural background of the agents, we compared impression of Germans, Americans and Arabs observing computer-animated interactions from the three countries. Only in the German stimulus sample the status roles could be recognized above chance level. However we found significant correlations in dominance perception across all countries. (...) Significant correlations were only found for evaluation between German observers and observers from the other two countries. Perceived dominance uniformly predicted the assignment of status-roles in all cultures. Microanalysis of movement behavior further revealed predictive value of specific nonverbal cues for dominance ratings. Results support the hypothesis of universalities in the processing of dominance cues and point to cultural specificities in evaluative responses to nonverbal behavior. (shrink)

The importance of prescription drugs to modern medical practice, coupled with their increasing costs, has strengthened imperatives for national health policies that ensure safety and quality, facilitate affordable access, and promote rational use. Australia has made universal and affordable prescription drug coverage a priority for decades, within a policy framework that emphasizes equity and increasing transparency in coverage design and payment decisions. By contrast, the U.S. lacks such a national policy. Furthermore, federal Medicare reforms aimed at making appropriate drug coverage (...) affordable and accessible employs two icons of the U.S. perception of fairness - the right to choose and the right to challenge coverage design limits - that mask the limited nature of the assistance. As the U.S. seeks to impose its values and priorities on other nations through the negotiation of bilateral and regional trade agreements, it becomes important to consider the two national experiences, in order to avoid trading illusory notions of fairness for true population equity. (shrink)

The role of government in assuring population access to affordable and appropriate health care represents a central question for any nation. Of particular concern is access to prescription drug coverage, not only because of the vital role played by drugs in modern medicine, but also because of their high costs. This article examines the sharply contrasting prescription drug coverage and payment policies found in Australia and the U.S. – strong political allies and international trading partners – and describes how key (...) U.S. interests have sought, through an aggressive trade agenda, to expand markets for U.S. goods and services, even when market expansions clash with other nations’ contrasting emphasis on social equity and fairness. Indeed, the nation’s bilateral free trade negotiations have brought the contours of this policy schism into sharp relief. (shrink)

There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration, and 83.1% reported (...) long sleep onset latency. Total anxiety symptoms were related to all sleep variables after controlling for age and sex. Furthermore, all anxiety symptom sub-types were associated with insomnia and sleep onset latency, whereas most anxiety subtypes were associated with sleep duration. Adolescents’ depressive symptoms accounted for most of the anxiety-sleep associations, emphasizing the importance of depressive symptoms for sleep. However, anxiety was associated with insomnia and sleep onset latency also among youth with low levels of depressive symptoms. The findings suggests that primary health care workers should assess sleep duration, sleep onset latency, and insomnia in help-seeking adolescents with anxiety. (shrink)

The human genome contains about 30,000 genes, each creating several transcripts per gene. Transcript structures and expression are studied by high‐throughput transcriptomic techniques using microarrays. Generally, transcripts are not directly operating molecules, but are translated into functional proteins, post‐translationally modified by proteolysis, glycosylation, phosphorylation, etc., sometimes with great functional impact. Proteins need to be analyzed by proteomic techniques, less suited for high‐throughput. Two‐dimensional polyacrylamide gel electrophoresis (2D‐PAGE), separating thousands of proteins has developed slowly over the past quarter of a century. (...) This technique is now quite reproducible and suitable for differential proteomics, comparing normal and diseased cells/tissues revealing differentially regulated proteins. 2D‐PAGE is combined with protein‐identification methods, currently mass spectrometry (MS), which has been significantly improved over the last decade. Other proteomic techniques studying protein–protein interactions are now either established or still being developed, such as peptide or protein arrays, phage display, and the yeast two‐hybrid system. The strengths and weaknesses of these techniques are discussed. BioEssays 26:901–915, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Although many aspects of the physiological and pathophysiological mechanisms remain unknown, recent advances in our knowledge suggest that the CREC proteins are promising disease biomarkers or targets for therapeutic intervention in a variety of diseases. The CREC family of low affinity, Ca2+‐binding, multiple EF‐hand proteins are encoded by five genes,RCN1,RCN2,RCN3,SDF4, andCALU, resulting in reticulocalbin, ER Ca2+‐binding protein of 55 kDa (ERC‐55), reticulocalbin‐3, Ca2+‐binding protein of 45 kDa (Cab45), and calumenin. Alternative splicing increases the number of gene products. The proteins are (...) localized in the cytosol, in various parts of the secretory pathway, secreted to the extracellular space or localized on the cell surface. The emerging functions appear to be highly diverse. The proteins interact with several different ligands. Rather well‐described functions are attached to calumenin with the inhibition of several proteins in the endoplasmic or sarcoplasmic reticulum membrane, the vitamin K12,3‐epoxide reductase, the γ‐carboxylase, the ryanodine receptor, and the Ca2+‐transporting ATPase. Other functions concern participation in the secretory process, chaperone activity, signal transduction as well as participation in a large variety of disease processes. (shrink)

This article investigates the original Chinese sources for two circular trigram arrangements that have played a crucial role in numerology associated with the Book of Changes since the Song dynasty. While attempting to clarify the nature and the origins of these and related diagrams, recent secondary literature on topic is reviewed, especially the influential articles by Schuyler Cammann.